Phacoemulsification and IOL implantation for primary angle closure glaucoma with cataract

Objective To study the preliminary clinical outcome of phacoemulsification and IOL implantation for angle closure glaucoma with cataract. Methods Thirty-three eyes of 31 patients with primary angle closure glaucoma with cataract who had undergone phacoemulsification and IOL implantation were included in the study. Changes in the anterior chamber angle, central anterior chamber depth (CACD), IOP and preoperative and postoperative visual acuity were observed. The patients were followed up from 1.5 to 3 years. Results After a mean postoperative follow up of (22.50±4.50)months, the anterior chamber angles were wider and the ciliary bands were easy to observe when examined by gonioscopy. The CACD had increased from a preoperative mean of(1.60±0.25)mm to (3.30±0.35)mm postoperatively (t=6.24, P=0.000). The anterior chamber angle had become wider and more open when examined by ultrasound biomicroscopy postoperatively. Mean IOP had significantly decreased from a preoperative mean of (24.43±1.61)mmHg that was controlled by medication to a postoperative mean of (14.99±0.65)mmHg (t=5.28, P=0.000). Best corrected visual acuity had improved postoperatively in all eyes (χ2=63.47, P0.01). Among the results for best corrected visual acuity, 6 eyes improved to 4.4～4.5, 18 eyes improved to 4.6～4.7, 6 eyes improved to 4.8～4.9, and 3 eyes improved to ≥4.9. Conclusion Phacoemulsification and foldable IOL implantation can be a good alternative for primary angle closure glaucoma that is caused by cataract of the lens. It not only decreased IOP but also improved visual acuity.